Prevalence and associated factors of metabolic syndrome in patients with schizophrenia - A multicenter cross-sectional study in China

Sep 30, 2026

Metabolic syndrome (MetS) shows high prevalence among people with schizophrenia, yet regional differences and data from large hospitalized samples in China remain limited. This multicenter cross-sectional study analyzed 3,042 participants from 25 hospitals in Zhejiang Province (Apr–Dec 2022). MetS was defined using Chinese Diabetes Society, NCEP ATP III, and IDF criteria. Overall prevalence reached 34.9%, 42.6%, and 38.9% respectively, with higher rates in females under NCEP ATP III or IDF. BMI and comorbid endocrine diseases were linked to increased MetS odds, supporting early screening.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Introduction

Study rationale and background

Methods

Participants and setting

MetS definitions

Statistical analysis

Results

Overall prevalence under different criteria

Sex differences and age pattern

Associated factors

ARTICLE OPEN Prevalence and associated factors of metabolic syndrome inpatients with schizophrenia: a multicenter cross-sectional study in China Zhengluan Liao 1,29, Junjie Lin2,3,29, Yaguan Zhou2,3, Suhong Ye4, Haihang Yu5, Xilong Jin6, Lixiu Wei7, Guidong Zhu8, Zhiyong Lan9, Kedeng Fu10, Tiantian Zu11, Li Ni12, Yingying Dong 13, Heqiu Wang14, Yong Zhou15, Wei Lv16, Juan Huang 17, Hongfei Wang18, Xueming Xu19, Xiao Qian20, Wanzhen Wu21, Liying Liu22, Huabin Liu23, HuanPing Zhan24, Yanbo Chen25, Zhilian Pi26, Minghua Xie27, Xiaolin Xu 2,3,28 ✉ and Enyan Yu1 ✉ | | | | | --- | --- | --- | | | Metabolic syndrome (MetS) is highly prevalent among individuals with schizophrenia. However, substantial regional variation exists, and evidence from large samples of hospitalized patients in China remains limited. This study aimed to estimate the prevalence of MetS and to explore its associated factors among individuals with schizophrenia in China. We included 3042 participants with schizophrenia from 25 hospitals in Zhejiang Province from April to December 2022 . MetS was deﬁned according to the Chinese Diabetes Society (CDS) criteria, the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria, and the International Diabetes Federation (IDF) criteria. The prevalence of MetS was estimated using the Clopper-Pearson method, and generalized additive models were used to ﬁt smoothed age-speciﬁc prevalence curves. Multivariate logistic regression was used to explore potential factors associated with MetS. The overall prevalence of MetS was 34.9%(95% conﬁdence interval [CI]: 33.2–36.7%), 42.6%(40.9–44.4%), and 38.9%(37.2–40.7%) based on the CDS, NCEP ATP III, and IDF criteria, respectively. The prevalence of MetS was signiﬁcantly higher in female participants with schizophrenia compared to their male counterparts when applying the NCEP ATP III or IDF criteria. In addition, after reaching the age-speciﬁc peak, MetS prevalence declined in male participants but stabilized in females. High BMI (OR: 1.30 [1.27–1.33]) and comorbid endocrine diseases (OR: 1.79 [1.48–2.17]) were associated with increased odds of MetS. Metabolic syndrome is highly prevalent among individuals with schizophrenia, regardless of the diagnostic criteria used Early identiﬁcation and screening of metabolic abnormalities in individuals with schizophrenia | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | .
should be considered. | | | | | | | | | Schizophrenia (2026)12:4; [https://doi.org/10.1038/s41537-025-00707-w](https://doi.org/10.1038/s41537-025-00707-w) | | | | | | INTRODUCTION Schizophrenia is a group of severe mental disorders of unknown etiology, characterized by a heavy disease burden and high disability rate, and affecting approximately 1% of the population across all age groups1. It was reported as the third leading cause of mental disorder-related disability-adjusted life years in 20192. Compared to the general population, individuals with schizophrenia have a reduced life expectancy of 15–20 years3. This excess mortality arises from a range of conditions and diseases, including cardiovascular diseases (CVDs), endocrine disorders, respiratory diseases, comorbid substance use disorders, and suicide, with CVDs contributing the greatest absolute mortality burden4,5. The upstream drivers of cardiovascular diseases in schizophrenia encompass smoking and substance abuse, physical inactivity and unhealthy diet, adverse metabolic effects of antipsychotic medications, and limited access to healthcare and social support services. These interconnected factors collectively lead to increased cardio-metabolic burdens such as obesity, insulin resistance, dyslipidemia, and hypertension5,6. Metabolic syndrome (MetS) refers to a clustering of metabolic abnormalities such as dyslipidemia, hypertension, and insulin resistance,

FAQs

How was metabolic syndrome defined in this study?

MetS was defined using three sets of criteria: Chinese Diabetes Society (CDS), NCEP ATP III, and International Diabetes Federation (IDF) criteria.

What was the overall prevalence of MetS among participants?

The overall prevalence was 34.9% (CDS), 42.6% (NCEP ATP III), and 38.9% (IDF), with corresponding confidence intervals reported in the study.

Which factors were associated with higher odds of metabolic syndrome?

Higher BMI and comorbid endocrine diseases were associated with increased odds of MetS, based on multivariate logistic regression.

Sep 30, 2026

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